ENDOSCOPIST DIRECTED PROPOFOL SEDATION IN EUS: PREDICTIVE FACTORS OF SEVERE ADVERSE EVENTS

Aims Severe adverse events including hypoventilation and laryngospasm during EUS are frequently related to the wider tip of the echoendoscopes.

AIM To determine predictive factors of adverse events during digestive EUS procedures in anesthesiologist or endoscopist directed propofol sedation scenario.

Methods Analysis of a prospective bicentric registry 2018-2021. Diagnostic and therapeutic EUS procedures in consecutive patients were included. Type of sedation (endoscopist or anesthesiologist), echoendoscope (radial/linear) and risk factors for complications of propofol sedation were recorded (ASA, OSAHS, Performance status, facial characteristics, obesity, and associated comorbidity).

Results 735 patients were included (age: 65±; 47% women). Propofol: 310 ml (IQR: 220-435); Midazolam 0 ml (IQR: 0-2 ml). Severe adverse events occurred in 31 (4,2%): 3% laryngospasm, 1,4% Sat02<75%. Multivariate analysis detected Retrognathia (OR: 3,17; 95%IC: 1,30-7,74), Anesthesiologist directed sedation (OR: 2,48; 95% IC: 1,15-5,34) and OSAHS (OR: 3.01; 95% IC: 1,41-6,43) as predictive factors of severe adverse events.

Conclusions A trained sedation endoscopist team can administer propofol sedation in EUS with less adverse events than anesthesiologist directed sedation.

Publication History

Article published online:
14 April 2022